LVF Presents The Vision Rehabilitation Therapist
Seminars@Hadley
LVF Presents The Vision Rehabilitation Therapist
Presented by
Ed Haines
May 19, 2016
Ed Haines
Welcome, everyone. I was a little nervous, we didn't have much
of a turnout until just recently, so we've got a good amount of
folks that are participating today. Welcome to you all. This
presentation is titled "The Vision Rehabilitation Therapist, Your
Advocate for Independence." I, in addition to moderating today's
seminar, I am also presenting. My name is Ed Haines and I'm an
instructor here at Hadley, and also a member of the Seminars at
Hadley team.
Just to give you a little background, I started working
full-time at Hadley about a year ago. I've worked part-time for
Hadley for quite some time but I started working at Hadley about a
year ago. Before that time, I've worked for many years as an
itinerate vision rehabilitation therapist. By "itinerate," that
means I traveled every day. I worked primarily in a rural setting
in people's homes. Honestly, it was a terrific job and really a
terrific opportunity to learn firsthand how low vision affects the
lives of older adults. It also was a great opportunity to observe,
over the years, what works and what doesn't.
So, during my career as an itinerate vision rehabilitation
therapist, and by the way, I'm going to start saying "VRT" really
soon, because vision rehabilitation therapist is a mouthful and
this term's going to come up an awful lot. So, during my career,
it's been my observation that often the individuals I work with are
not sure, at least initially, about what I do or how my role is
different, for instance, from say a visiting nurse or a home
healthcare provider. Honestly, this is natural because a lot of
times, and it depends on the individual, there may be several
agencies and professionals providing a whole range of services to
older adults in their homes. It really is hard to keep track of who
is who, particularly if staff keeps changing and people come and
go, so it's really hard to keep track of who's visiting when. It
was very common for me to arrive for the first time at a person's
home and discover that they really weren't sure why I was there.
They also weren't really sure who sent me or what I actually
planned to do.
If there are VRTs in the audience today listening, you'll know
that sometimes a lot of unnecessary time is spent explaining the
purpose of that first visit, which is what I'm going to concentrate
on today. I will tell you, I can't count how many times I've
knocked on the door of a home for the first time and I've been
greeted by a family member who then yells back into the house
saying, "That guy from the blind place is here," and that's about
the extent of the family's knowledge of my purpose. So, the reason
I'm presenting today is that I think it would be helpful for folks
who are going to be working with a VRT to understand a little bit
about the job of the VRT and how they can work as a team with the
VRT, and how the VRT fits in with their whole process of
adjustment.
So, beginning now, I'm going to be addressing the rest of this
presentation to those individuals. I'm going to be talking to folks
who may be awaiting the visit from a vision rehabilitation
therapist for the first time or they may have called an agency and
asked for a visit, and they're preparing to work with that
individual. So, I'm going to be addressing those folks that
anticipate that they may be working with a vision rehabilitation
therapist.
Often, the first diagnosis of an eye disease that causes low
vision occurs in the office of an ophthalmologist or an
optometrist. These are medical professionals and they will have a
ton of information on the health of your eyes and there will be a
lot of discussion during doctor visits about treatment and
prognosis. But very little information is given out about what to
do when the treatments are over and it's time to go home, and
that's normal. Medical professionals, especially ophthalmologists,
are specialists. They're focused on the physiological aspects of
low vision. That means the medical aspects, the mechanical
functioning of the eye. So, here's the difficult part, however;
individuals are often told by an ophthalmologist, and this is
especially when they have a diagnosis of say, dry macular
degeneration, or treatments for other diseases have been exhausted,
they are told by their eye doctor that, "Nothing more can be done."
Now what that eye doctor means, of course, is that they know of no
further medical treatments to reverse the damage done to visual
acuity by whatever eye disease the individual happens to have, like
macular degeneration.
In my experience, the person with low vision who's just had the
diagnosis hears that statement from a very different perspective. A
person with low vision is commonly less concerned with the
physiology of their eye or their acuity measurements than with
knowing they can continue to do all the things they want to do. In
other words, persons with low vision are more concerned with the
functional implications of their vision loss rather than with the
medical or physiological implications. So, when they hear an eye
doctor say there's nothing more that can be done, they may think
that the doctor is speaking about their functional level, when in
fact, the doctor is speaking about eye physiology. Here's the
important part, functionally speaking, or in terms of a person with
low vision still conducting their lives independently, a whole lot
can be done, we know this. A great deal can be done. This is where
the vision rehabilitation therapist comes in.
Now let me give you a parallel really quickly, just to put this
in context. If you fall and you break your hip, after you have
surgery and get the hip repaired, you may go to a rehab facility or
you may have home-based physical therapy, but you're going to have
a whole lot of therapy so that you can begin to walk again and
function normally. The same process holds true when you lose some
vision. You need therapy so that you can return to functioning
normally. That means doing the things you want to do. The goal of
the VRT is to help you do this.
Okay, so what's the job of a vision rehabilitation therapist?
Here I'm going to read you the definition written by my mentors in
graduate school. Here it is, "To instruct people with vision
impairments in utilizing the adaptive skills that allow them to
cope with everyday life." I'm going to read that again because it's
important. "To instruct people with vision impairments in utilizing
the adaptive skills that allow them to cope with everyday life."
It's a subject for maybe a lot of other presentations, to talk
about specific adaptive skills, but we'll talk about them in
general terms. These adaptive skills fall under some general
categories. These can include home management, that means cooking,
cleaning, home repair, et cetera. Personal management, which can
include managing medications and making sure that you can shave and
do your hair, things like that. Communications, and that's a broad
term. Communications, it can encompass everything from reading to
using computers to financial recordkeeping to using the telephone.
Leisure activities is another important category. Counseling is one
as well, and that means assisting with the emotional adjustment to
vision loss. Just as important, working with family and other
caregivers to help them adjust as well. Finally, low vision skills
themselves, and that can include working with magnifiers, finding
what kind of lighting is optimal, working with eccentric viewing,
glare, that kind of thing. Those are some of the general categories
of adaptive skills that VRTs are experts in and are there to help
instruct people with low vision.
If you're fortunate, you may actually have the opportunity to
attend a rehabilitation center for the visually impaired. A lot of
VRTs work in that setting and that's a wonderful opportunity. I
encourage anyone who listens to this in the future, if they're
wondering whether to go to a rehabilitation center, I certainly
encourage it. They can get concentrated instruction and it's a
wonderful environment.
This presentation today is meant to focus on the VRT that visits
and works with a person in their home. I'm doing that because there
really are some unique characteristics to your relationship with a
VRT who comes to your home, and there are a lot of things you can
do if you're expecting a visit, to optimize that relationship.
That's what I'd really like to focus on now for the rest of this
presentation.
I mentioned earlier that often individuals are confused as to
why I arrive at their home. A lot of times, folks are not really
sure how it all came about. So, let me explain how the process
works a little bit. The first stage of our relationship happens
when the VRT is sent a referral regarding your condition. In other
words, you or someone else, maybe a doctor, maybe someone at a
senior center, maybe a visiting nurse, a family member, et cetera.
Someone or yourself have noticed that you're experiencing some
functional limitations due to low vision. A decision has been made
that you would benefit from some new adaptive skills. Either you or
someone else has therefore then contacted a vision rehabilitation
agency.
Before I, as a VRT, visit you, I've received a referral about
you. Once I get the referral, usually it's a letter or phone call
regarding your condition and possible need for services, then I or
someone representing me calls you. Hopefully you're aware of the
referral, but you know, it's common actually for me to have
received referral on a person's behalf and when I call them,
they're not aware the referral was made. It's possible you might
not be aware of the referral if someone else sent it. It's also
reasonable that you may or may not remember that a referral has
been made to a VRT because you've been referred to a whole lot of
medical and other professionals and it's awfully hard to keep
track, and that's certainly understandable. If you're not aware of
the referral, the VRT will explain who they are, who referred you,
and why they're calling.
Now, a little caveat here, at this juncture, I'd just like to
explain that VRTs can work from several different kinds of
agencies. They may work for a private, non-profit agency for
persons with vision impairments, or they may be working for a state
agency, a division for people with vision impairments, or they may
work for a federal agency like the VA. One thing I want to just say
here quickly is that the name of that agency they work for may
contain the word "blind" in the title. Please don't let that
confuse you. If they are calling you, it's because they feel they
can offer you some assistance and that you don't have to be blind
to be eligible for their services. So, don't be put off by that.
The first phone call when they call you, it may be just to confirm
the information of a referral, but it may also be to schedule an
initial appointment in your home.
So, I'd like to talk about scheduling just a little bit, because
it's really important, and I'd like to talk about some things for
you to consider when you're deciding on an appropriate day and time
for your VRT to visit with you. Okay, scheduling; the first thing
is to just make sure you have enough time for that initial VRT
visit. The first visit is usually an assessment, and that's where
the VRT takes stock of how you do things, what things you'd like to
accomplish, what your goals and priorities are, and I will be
talking more about the assessment later.
The main point here is that this first visit will probably take
some time. It can take up to two hours, it depends, but certainly
at least an hour. So, make sure you have time for the VRT to
conduct a complete assessment. Ask them how much time they'll need,
they'll know. Secondly, it's helpful if you don't have any pending
appointments immediately after your visit with the VRT. Try to stay
flexible that day. The visit may be tiring. It's also very helpful
if you don't have any visitors due to arrive shortly after your VRT
does. I understand that's really not always possible. Other
professionals, like visiting nurses, et cetera, they have tight
schedules and you just can't juggle them all, and that's perfectly
okay. If it's possible, try to make sure there's a little lead time
between appointments or visits.
Also, if possible, try if you can, to make sure there are no
other professional-type individuals visiting at the same time and
circumstances may require that. The people I'm talking about are
house painters, plumbers, cable TV repairmen, et cetera, who may be
a little demanding of your attention or may be somewhat of a
distraction. Sometimes if there's an emergency in the home, you
need someone there and there's no choice, but if it's possible, try
to avoid scheduling those kind of folks at the same time. You
really are going to need to give your VRT as much undivided
attention as possible.
Now another consideration when you're scheduling is to make sure
you schedule at a time when you're at your best. By that I mean, if
you're not a morning person, see if you can schedule a visit in the
afternoon. If you have dialysis on a certain day, it's probably
best to schedule your visit on the recovery day when you feel a bit
stronger. Also, if you only have enough energy for about an hour or
any given amount of time, tell your VRT that.
This is really important, it's important for you to think about
who you want to be present at your meeting with your VRT. It is
totally common and acceptable and natural to want someone there
with you, like a spouse or a relative or a child, et cetera.
Actually, that's often really, really desirable. Sometimes, spouses
and family can help you remember all the information that you need
to remember. There's going to be a lot of information that's going
to be exchanged during your first meeting and undoubtedly, it would
be helpful to have someone there to help you remember or to write
it down. That being said, sometimes having too much family present
can be a distraction. I have found in my experience, especially if
children are present. If you are scheduled to babysit your
grandchildren on the day the VRT is arriving, probably you need to
let them know because they'll want to schedule a time when your
grandchildren are not demanding your attention. I have to say, I
have nothing against kids, but you need to focus. If you do decide
to have family present, make sure they are in the room, there to
listen and participate. As I said, it's really best if there aren't
any other distractions, so this visit will include a lot of
questions and it will be tiring. Family members that are present
will need to be focused and hopefully not watching TV or cleaning
your house or engaged in other activities. They'll also need to
stay on the subject and the subject is you. The VRT is there to
listen and to talk with you.
Finally, and this is not very important, but it comes from my
own personal experience. If you have a pet, when you're scheduling,
let the VRT know that you have a pet. For one thing, the VRT may be
visually impaired him or herself and they may be using a guide dog.
So, they'll need to know if there's a pet in the house,
particularly another dog. Also, if pets are unpredictable, it helps
if you put them in a bedroom or other confined place away from
where you'll be meeting. I have, in the past, been bitten several
times, mostly by small dogs. In fact, always by small dogs, and I
remember one visit where, the minute the door opened, the dog ran
out into the neighborhood and I spent the first half hour of my
visit chasing the individual's dog. So, if the dog had been in a
bedroom locked up when I arrived, we would've saved ourselves a
little time. If you have unpredictable pets, please confine
them.
Alright, we've talked about some things that you need to
consider when scheduling your first visit and now I'd like to
mention a few things you can do to prepare for your first visit.
This is just a basic list and it doesn't fit everybody, but here's
the basic list. If you use any magnifiers, either handheld
magnifiers or electronic magnifiers, or if you use sunglasses or
any kind of low vision device, it really helps if you have those
ready to show the VRT when they arrive. The reason for that is, the
VRT will really want to know what works for you and what doesn't
work for you. So, have them all in one place, that way you don't
have to go searching around for them when the VRT asks about
them.
If you take medications, have your medications handy. The VRT,
part of the assessment, they will want to know what you take and
when you take it. The reason for that is, there may be ways to make
this process easier for you. Now, here's another important thing
you can do when you're preparing for a visit; make a mental list.
You can have a family member help you with this. Make a mental list
of things that you used to do that vision loss is now making more
difficult or things that you have stopped doing altogether. If
possible, just try to prioritize those things, just in your mind.
Decide what's most important to you. Now, I'll tell you right off
the bat, it's okay to put "driving" down on that list. Giving up
driving is a shock for everyone, so it's okay to say driving. Even
though your VRT, I will tell you, probably will not be able to help
you with driving, but it's normal to feel that stopping driving is
an important loss.
I'm going to say something now that I'm going to repeat several
times in this presentation; your visit with the VRT is not a test.
There are no right or wrong answers to questions. Your VRT wants to
know your feelings about vision loss. They will want to know what
you miss and what you'd like to continue to do. Finally, make a
mental note of the history of your vision loss because the VRT will
be asking some questions about this. For instance, how long, just a
ballpark figure, how long has it been since you stopped driving or
how long since you were unable to read a newspaper? When were you
first diagnosed? It doesn't have to be the exact date but just
approximately, and who was the person who made that diagnosis?
Also, they'll want to know, if they don't know already, the name of
your eye specialist, your ophthalmologist, and they'll be curious
about how often you go to see that individual. This is all
information that will be helpful to the VRT as they help you design
an instructional plan to help you regain your independence.
Okay, we've talked about things to do to prepare for your VRT
visit and I'm going to give you just a short list of a few things
not to do, and it's short. First of all, don't clean your house in
preparation for a visit, unless you want to for your own sake. As I
mentioned before, the VRT is a professional who wants to see how
you normally live, they're not a houseguest. This is not a test. If
possible, unless there's a real serious reason, try not to cancel
your appointment at the last minute. Most VRTs have a pretty large
case load and they're stretched pretty thin, so they may not be
able to get back to see you soon if your appointment is cancelled
at the last minute. Obviously, life gets in the way, so they'll be
completely understanding if there's a good reason. Finally, and I
told you I was going to repeat this, this is really important,
don't be nervous. Working with your VRT is not a test. The VRT does
not require you to do anything you don't want to do; this is all
about you. It's all about finding ways to help you stay
independent. So, as I said, there are no wrong things you can say
and there are no wrong questions to ask.
Well, you know a little bit more now about what the job of the
VRT is and hopefully you know a little more now about that first
phone call, and hopefully how to prepare for and schedule your
first visit. So, I'd like to talk a little bit now about that first
visit because after the initial contact, you'll understand from
your own VRT what you'll be working on next and what the subsequent
visits will be like and how they'll be planned. I'm really talking
about this first visit when you haven't met them. On this first
visit, like I said, the VRT is there to find out about you and
finding out about your priorities can take some time. The VRT may
spend some initial time just talking about things not related to
your vision loss, just getting to know you. They may talk about
your family or the weather or your pets, your hobbies, your garden,
et cetera. It's okay to relax. I'll say it again, this is not like
a doctor visit and it's not a test.
If you remember at the beginning of this talk, I spoke about
some of the categories or areas that the VRT will be helping you
with. In this first visit, they are learning about you and trying
to find out which of these categories are priorities for you. They
will want to know what's important to you and to do this, they will
eventually be asking some fairly detailed questions, just about how
you go about your daily life. That's what takes the bulk of the
time in the first interview.
So, I'd like to talk a bit more in detail about the kinds of
questions they'll be asking. I do this so that if you are someone
preparing for a VRT visit, you can think about these questions
ahead of time. That's very helpful, actually, because sometimes
forethought can give you a better idea of your priorities. The VRT
wants to know how you go about your daily life, how you do what
needs to be done, and what activities your vision loss has made
difficult, what things are important to you. Another reason I
mention it's good to think about these questions ahead of time is
that sometimes, if we answer quickly, without a lot of thought, we
don't answer thoroughly. Let me be clear about what I mean. As I
said, the VRT is going to want to know how you do specific daily
tasks, like how you turn on your stove or how you do your laundry,
how do you tell time.
Often, I have found, people have already made some adjustments
to low vision and they've come up with some solutions to doing
tasks on their own, often great ones, it's terrific. Sometimes,
those adjustments can be improved upon and it's important, when the
VRT asks you how you do something, you accurately describe how you
do it. If you've already got a solution, it's kind of tempting to
say, "I've got that covered," or, "I don't have a problem with
that." Often, I've noticed people respond that way because they
just don't want to cause a lot of trouble and they're being polite,
and they don't think that the small difficult they're having with a
certain task is worth mentioning. That's normal, but there may, in
fact, be a way to accomplish a task in a manner that you haven't
thought of, in a way that might be easier. That's what the VRT is
there to help you with.
I just want to give you some examples of what I mean by these
kind of accommodations. If you can't see the telephone keypad to
dial accurately anymore, to dial a phone number, a reasonable
accommodation would be, and people have thought of this, is just to
dial zero. Put a bump dot or something or a mark on the zero and
let the operator do the dialing for you. That works, that's a
solution, but it actually costs some money and it may not be the
best solution. There are ways, in fact, of non-visually navigating
a telephone keypad, so that anyone can accurately dial numbers on
their own.
It's possible to use different kinds of sticks or canes to help
you determine where steps and curbs are when you're outside the
house. I have seen people use ski poles, fishing rods, you name it.
The VRT may know of a different kind of cane that might be more
effective and safer. I will tell you, I can't count the number of
times I've asked folks about how they tell time. They say, "That's
no problem, I can tell time." And I've asked them, "Well, how do
you tell time?" and they'll tell me, "Well, I get up from my chair
here and I walk over to the wall clock in the kitchen and I put my
face right up to it and I can see the clock face." Well, that's an
accommodation and it works, there's nothing wrong with that. You
know what? There are some accessible clocks and watches that make
that job just a whole lot easier.
Occasionally, a solution to a difficult task is to just let
someone else do it for you. That's also fine, but if you used to
enjoy certain tasks or you would prefer, for personal reasons, to
do them on your own, let the VRT know. For instance, if you prefer
to do some of your own financial record keeping, just for privacy
reasons, or maybe you've given up baking for pleasure because it's
hard to operate the oven, or maybe, this is common, you let someone
else order for you in a restaurant because it's hard to see the
menu. Those are things that possibly you could return to doing
independently.
Here's the main point of the VRT's visit, the VRT doesn't want
you to just get by. The VRT doesn't want you to settle, so don't be
afraid to give honest answers when questions are asked about how
you accomplish your daily routine. That's why I'm going to talk now
a little bit about the kinds of questions because as I said, if you
give it a little forethought, you might come up with some more
accurate answers and you might come up, with the VRT's help, with
some better solutions.
We talked about the questions the VRT's going to ask you in
general terms but now I'd like to be just a little more specific so
you know what to expect. I mentioned earlier, right at the
beginning of this presentation, that there are certain categories
of activities that the VRT will be concentrating on. Let's go over
them in a little more detail now.
First, the VRT is going to want to know about the subject of
food. Specifically, they'll want to know how you do your shopping,
are you able to find items in the store, can you read price tags
and ingredients on boxes, can you find the food items in your
kitchen cabinets once you've brought them home? In other words, can
you differentiate between a can of noodle soup and a can of lentil
soup, for instance? They'll want to know how you manage the tasks
associated with cooking, like using your stove or oven, or setting
your microwave. They'll want to know how you follow recipes, if you
still use recipes, if you enjoy cooking, and how you measure
ingredients. If there are specific parts of food preparation that
you used to enjoy and no longer try to do because of vision loss,
they will definitely want to know about those.
I mentioned at the beginning of this presentation that the
category of communications is important and it really, really is.
Communication is a general category, but it refers to how you keep
track of the world and how the world keeps track of you,
essentially. It's a category referring to how you use the phone.
How do you write or read letters? Do you make lists for others that
they can read, or do you make lists that you can read? Do you read
for pleasure? Also, they'll want to know how you keep track of
appointments. Do you have a calendar that you can see clearly?
Also, as I mentioned, they'll want to know how you tell time.
Another important category is home management, and that includes
things like house cleaning, doing dishes, measuring detergents,
operating laundry machines, folding clothes, ironing, all
thosekinds of things. They'll be asking a lot of questions about
home management. The VRT will also want to know about your
technology usage. They'll want to know if you have a computer that
you no longer use, what kind it is. Sometimes folks have an iPad or
a Kindle sitting around that maybe a grandchild gave to them or
they bought and they thought they might be helpful, but they're not
really using. The VRT will want to know if there's any technology
in your life, what you're using it for and if you've given up using
it because of your vision loss.
Your VRT will also be interested in how you're coping with
personal management. As I mentioned earlier, that means things like
shaving, make-up, doing your hair. I think personally, the most
important part of personal management is medication management. You
need to be able to know that you can independently take the right
pill at the right time. The VRT will want to know if you're
dropping pills and if you do drop them, can you find them again?
For those folks who have diabetes, the VRT will want to know about
your diabetes management. They'll want to know if you can measure
your own blood sugar, if your meter's legible to you. If you have a
talking meter, they'll want to know if you can draw your own
insulin, et cetera.
I also mentioned low vision skills and if you remember, when I
talked about preparing for your first visit, I said it'd be a good
idea to gather all your magnifiers together. They will want to know
all about the magnifiers you're using and they'll want to know
exactly how you use them. in other words, what jobs you use them
for. They'll want to know what you like about them and what you
don't like about them. Now, low vision skills, as I mentioned, also
include assessing the lighting in your home and asking you about
your lighting requirements. Do you need a lot of light to be able
to see something close up? Are you sensitive, however, to glare
inside or outside? Do you have task lighting? If you wear
sunglasses when you're outside and if you do, what kind of
sunglasses you wear.
Now, the VRT will also want to know about safety and they'll
probably ask you if you're tripping over things or bruising your
shins on coffee tables or open dishwasher doors, that kind of
thing. They may ask if you use a support cane and this is
something, in my part of the Midwest, I always ask folks, I ask
them if their washer and dryer is down in the basement, because it
often is. Individuals with low vision find themselves having to
cart their laundry up and down very dark basement stairs. It's
always a concern of mine. So, that's something I'll ask. They'll
want to know if you call 911 with confidence. Can you call 911 with
confidence if you need to, if someone else in your family needs
help? Are you confident finding exits in your home? Also, if you
need assistance when you're traveling to stores or church, et
cetera. If you need assistance when you're going upstairs or going
downstairs, or finding curbs, navigating sidewalks, that kind of
thing.
It's just as important for them to know about your leisure
activities, too, especially ones you've always enjoyed and
including the ones you've given up because of vision loss, if you
have. For instance, have you given up sewing because you can't
thread a needle anymore? Have you given up going out with friends
because dining out makes you nervous?
Finally, the VRT will want to know about your feelings about
your low vision. They really will want to know how you feel you're
adjusting. Almost as importantly, how your family members or other
caregivers are adjusting. They have a lot of information and can
give you lots of hints on how to talk about your vision loss to
family and friends and this is very important, how to communicate
when you do or you don't need help.
I'd like to go back now and sum up just a little bit. We talked
about what the VRT, the vision rehabilitation therapist, does.
We've talked about things to consider when scheduling a visit and
things you can do to prepare for a visit. Finally, we talked in
detail about that first visit and the assessment and the kinds of
questions that the VRT will be asking. If that sounds like a lot,
actually, it is. As I mentioned before, you and your VRT are a
team. You will be working together for possibly quite some time,
maybe months. This first visit will lay the foundation for the work
you both will do together in the time to come.
The most important thing is that you get to know each other and
you make sure your VRT understands your priorities. I say this
because, and I've said this several times already, sometimes the
VRT knows all this stuff that's going to help. They have all this
information in their head and they're eager to share it and that's
why they do the job in the first place. They may rush into some
solutions because they've done the job awhile and I'm speaking for
myself, and they don't take time to actually think about what the
person's own priorities are because they see so many wonderful
solutions out there they know will help.
There are just so many adaptive skills you can learn and aids
that can help. Sometimes, solutions require a bit of training, like
learning to use your computer again. Some solutions may be solved
quickly. For instance, a talking watch can help you tell time. A
magnifier can help you read your pill bottles. All those solutions
have to be tailored toward your own priorities.
I will mention, there's a few other ways, quite a few, that the
VRT can assist you. That can include, and don't be afraid to ask
them about this, that can include helping refer you to other
agencies or entities. They may help you sign up for the Library of
Congress Talking Book Program, if you're interested. They may have
contact information of a support group for people with low vision
and they'll know when that group meets in your area and how to get
a hold of them. They may be able to help you with a referral to
other agencies like the VA, or they may be able to help you sign up
for Hadley. All of these things come into play when your VRT and
you work together as a team.
Your VRT's job, really, is to inform you of what adaptive skills
and solutions are available and to help you prioritize which skills
and solutions you'd like to focus on. That's a lot, and normally, a
lot of it is just in the first visit. That's why I wanted to do
this presentation. Now, as you continue to work together, try to
keep open communication with your VRT. If your health changes or
your living situation changes, give them a call and let them know.
You will be working together, as I mentioned, possibly many months.
It's important to also keep in mind, your priorities will likely
change. This is the fun part because it's really common to be
inspired by early successes, to try things you thought you could
never do again. Often, people start out on one path and they
realize, Gosh, I'm such a success at this, I think I could do this
and this and this. For instance, if you learn you can thread a
needle with low vision, and there's a way to do that, you may
decide to take up sewing again. Once you learn how to safely
operate your oven, you may decide, Gosh, I really used to enjoy
baking, I think maybe I'd like to take that up. Your priorities
will change and as they change, make sure you communicate those to
your VRT.
Well, I'm going to close up now and just say that the most
important thing I can ask anyone who's expecting to work with a
VRT, the most important thing I can ask them to take away is to
keep open to possibilities. Your vision rehabilitation therapist is
there, and I'll repeat this, I said it during the beginning, your
vision rehabilitation therapist is there because there are things
that can be done. Skills and aids and solutions that can increase
your independence and your functional level. You really are a team
and you're working together toward one goal and that's your
independence. Alright, that's the end of my presentation. I'll
release the mic if anybody has any questions or comments. Also, if
there's any rehab teachers or vision rehab therapists in the room
who want to add any information to this that they think I could
use, please go ahead. Hi, Kelly, I could see your mic was on but we
couldn't hear you. Todd, thank you for the comment, I'm glad the
information was helpful.
Kelly
I was asking, how do you adapt your services when you're working
with people from different cultural or [inaudible 00:49:06]
backgrounds?
Ed Haines
That's a really good question. Depending on where you live in
the United States, a vision rehabilitation therapist may, in fact,
come in contact with a whole lot of different kinds of ethnicities
and backgrounds. I guess all I can say is the VRT has to be
flexible and compassionate.
I will say that there are some cultures that I've experienced
where it's definitely expected that the entire extended family will
be present when I'm working with an individual, and that's just
going to be the way it is, and that's fine. There also may be
times, I've worked with some individuals where, because I'm a male,
that individual was female and didn't really feel comfortable
working with me exclusively without anyone else present. You just
have to be flexible.
I am not bilingual, unfortunately, but I know a lot of VRTs,
especially in areas with high concentrations of Spanish speakers,
need to have that skill as well. Alright, do we have any more
questions? One more chance for questions and then I will launch the
survey.
Unidentified Female
I facilitated a low vision group, as well as being visually
challenged with AMD. I have one in the group who really, really
needs a VRT. How do I convince her that rather than going into an
assisted living situation, perhaps she should try the VRT
first?
Ed Haines
Well, it is tough. Sometimes people are in denial and I think
sometimes the best way to convince someone is just to get them to
be exposed to someone who's successfully living independently with
low vision. There may be members of your group and you yourself who
are already doing that. If they can see it works for others, it'll
work for them. I think peer pressure is one of the best things.
If they would agree to just an initial visit from a VRT, usually
that initial visit will be a positive experience. A lot of times,
I've found people are so relieved once I've met with them for the
first time that something could be done, that they are eager to
have me return. If you could just get her to agree to one initial
visit, that would be fantastic. Any other questions from folks?
Okay, I'm going to go ahead and close things up. I do have a
little bit of housekeeping at the end here. This seminar recording
will be archived on the Low Vision Focus website at
www.lowvisionfocus.org, as well as the Hadley Institute website,
www.hadley.edu. If you folks have access to any other recordings,
you'll know that they're available 24/7. Each of our seminars at
Hadley is now available as a podcast, so you can download it and
listen to it on your computer of mobile device. For those of you
who are on Twitter, Hadley's twitter hashtag is #Seminars@Hadley.
Again, thanks everybody for participating today. I do value your
feedback, we value your feedback, so please let us know what you
thought of this seminar and if you have future seminar topics or
ideas about this subject, please send an email to
[email protected]. So, again, everyone, thank you so much for
attending.
[End of Audio 53:00]
2016 Hadley Institute for the Blind and Visually ImpairedPage 28
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